Dynamics of<i>Helicobacter pylori</i>infection as a determinant of progression of gastric precancerous lesions: 16-year follow-up of an eradication trial

Mera, Robertino M.; Bravo, Luis Eduardo; Camargo, M. Constanza; Bravo, Juan Carlos; Delgado, Alberto; Romero–Gallo, Judith; Yépez, María Clara; Realpe, J.Luis; Schneider, Barbara; Morgan, Douglas R.; Peek, Richard M.; Correa, Pelayo; Wilson, Keith T.; Piazuelo, M. Blanca

doi:10.1136/gutjnl-2016-311685

Cited by 147 publications

(149 citation statements)

References 36 publications

(42 reference statements)

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“…Our results are significantly influenced by two trials: The study by Morgan et al[22] as the largest trial with 1463 PYs follow up, and the study by Mera et al[19] as the cohort with the longest follow-up time. The Mera study was the only cohort followed for more than 5 years; subjects with preneoplastic gastric lesions were enrolled from a geographically circumscribed region of Colombia, and thus, the results may not be generalizable to the remainder of Latin America.…”

Section: Discussionmentioning

confidence: 81%

“…The cumulative reinfection rate at the 5 and 7 year time points were 36.2 and 48.6 per 100 PYs, respectively. Recurrence rates from different countries were combined for the first 6 years, 12 and 16 years (only one study had follow-up beyond 5 years[19]). Recurrence rate were higher in the first six months and decreased afterwards.…”

Section: Resultsmentioning

confidence: 99%

“…This measure may be more important than the choice of initial antibiotic regimen and bacterial resistance rates, and is likely to differ by global region[19-21]. Latin America populations have high colonization rates of H. pylori , as well as a significant burden of gastric adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

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Helicobacter pylorirecurrence after eradication in Latin America: Implications for gastric cancer prevention

Corral¹,

Mera²,

Dye³

et al. 2017

WJGO

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AIMTo estimate Helicobacter pylori (H. pylori) recurrence rate in Latin America, a region with a significant H. pylori prevalence and gastric cancer burden.METHODSPubMed, LILACS, SciELO, Cochrane databases and abstracts from relevant meetings were reviewed. Information collected included: Participants’ characteristics, recruitment strategy, diagnostic modality, treatment arms, follow-up and recurrence rates. Recurrence was calculated using 100-patients-year rates, and data were pooled using a random effects model. The I2 statistic assessed between study heterogeneity. Meta-regression analyses evaluated for effect modifying variables.RESULTSLiterature search yielded 163 articles. Twelve studies involving 4848 patients from 9 countries met inclusion criteria. Four hundred and thirty-two reinfections were recorded in 5487 person-years of follow-up. Pooled analysis showed a recurrence rate of 7.9 cases per 100 person-years (95%CI: 5.3-10.5). Meta-regression revealed that neither the antibiotic schema, a second antibiotic course, nor the diagnostic modality had an impact on the observed risk of recurrence. The recurrence rate in the first year after treatment, predominantly recrudescence, was 11.2 (6.1-16.4) per 100 patient years. Recurrence in subsequent years, was only 6.2 (3.8-8.7).CONCLUSIONH. pylori recurrence rates in Latin America are significant, and with geographic variability, yet are acceptable based upon the current literature for consideration of large scale intervention trials. Further research in Latin America is warranted to evaluate the efficacy, cost-effectiveness, and potential adverse outcomes of proposed eradication programs.

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Section: Discussionmentioning

confidence: 81%

Section: Resultsmentioning

confidence: 99%

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Helicobacter pylorirecurrence after eradication in Latin America: Implications for gastric cancer prevention

Corral¹,

Mera²,

Dye³

et al. 2017

WJGO

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“…1 It is reported that approximately half of the global population is infected with H. pylori. [4][5][6] H. pylori eradication may reduce gastric inflammation, 7 prevent progression toward precancerous lesions, 8 and decrease the incidence of gastric cancer. [4][5][6] H. pylori eradication may reduce gastric inflammation, 7 prevent progression toward precancerous lesions, 8 and decrease the incidence of gastric cancer.…”

Section: Introductionmentioning

confidence: 99%

The effect of antioxidants on Helicobacter pylori eradication: A systematic review with meta‐analysis

Yang-Ou

Zhu

et al. 2018

Helicobacter

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“…Atrophy, intestinal metaplasia and dysplasia are considered pre-malignant lesions. The severity of the atrophy and metaplasia is quantified by the OLGA/OLGIM system, and in the research setting by the Correa histopathology score [21]. …”

Section: Introductionmentioning

confidence: 99%

Tipping the Scale Towards Gastric Disease: a Host-Pathogen Genomic Mismatch?

2018

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Purpose of Review Chronic infection with Helicobacter pylori infection is necessary but not sufficient to initiate development of intestinal-type gastric adenocarcinoma. It is not clear what additional factors tip the scale from commensal bacteria towards a pathogen that facilitates development of gastric cancer. Genetic variants in both the pathogen and host have been implicated, but neither alone explains a substantial portion of disease risk. Recent Findings In this review, we consider studies that address the important role of human and bacterial genetics, ancestry and their interactions in determining gastric disease risk. We observe gaps in the current literature that should guide future work to confirm the hypothesis of the interacting roles of host and bacterial genetics that will be necessary to translate these findings into clinically relevant information. Summary We summarize genetic risk factors for gastric disease in both H. pylori and human hosts. However, genetic variation of one or the other organism in isolation insufficiently explains gastric disease risk. The most promising models of gastric disease risk simultaneously consider the genetic variation of both the H. pylori and human host, under a co-evolution model.

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Dynamics ofHelicobacter pyloriinfection as a determinant of progression of gastric precancerous lesions: 16-year follow-up of an eradication trial

Cited by 147 publications

References 36 publications

Helicobacter pylorirecurrence after eradication in Latin America: Implications for gastric cancer prevention

Helicobacter pylorirecurrence after eradication in Latin America: Implications for gastric cancer prevention

The effect of antioxidants on Helicobacter pylori eradication: A systematic review with meta‐analysis

Tipping the Scale Towards Gastric Disease: a Host-Pathogen Genomic Mismatch?

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